This article addresses the subject of suicide and self-harm in a journalistic context. If you are personally experiencing psychological distress or a mental health crisis, please contact a mental health professional or a crisis support service in your country.
Since the beginning of this year, Egypt has witnessed a number of suicides, with April alone recording 7 consecutive incidents, the most prominent of which was the case of the Smouha woman in Alexandria who threw herself from the thirteenth floor, followed by other incidents; just two days later, a physiotherapy doctor took her own life by jumping from the eighth floor in the Nozha district of Cairo.
In another tragic incident, a veterinarian fell from the top of a balcony on the twelfth floor in the Kafr Tohormos area of Giza Governorate; she was later found to be suffering from “obsessive-compulsive disorder”. Two days later she was followed by another woman, who threw herself from the fifth floor in the Bulaq El-Dakrour area.
On 8 April, a young man ended his life by hanging from the top of the “Mazallat Bridge” in the Sahel district of Cairo, and 4 April saw another incident, when an elderly driver committed suicide by hanging himself from the fence of the Medical Commission headquarters in the village of Gheit El-Nasara, after repeated attempts to obtain a pension. Meanwhile, a doctor in her thirties ended her life by hanging inside her home in the Mayo area of Cairo.
Last January, Dr Ahmed El-Beily, undersecretary of the Ministry of Health in Sharqia, announced that the “Belbeis, Husseiniya and Ibrahimiya” central hospitals had received 4 cases of attempted suicide using grain tablets, among them a young girl and a young man in the prime of life, and the medical teams succeeded in saving their lives.
With the recurrence of suicide cases, which have stirred much controversy, the Ministry of Health called on citizens to make a point of turning to psychiatric medicine.
Despite the absence of recent statistics on the number of patients with mental disorders in Egypt, the latest survey issued by the General Secretariat of Mental Health revealed that about 25% of Egyptians suffer from mental disorders, while the proportion of those receiving treatment does not exceed 0.4%. The study showed that the most widespread disorders, “depression in particular”, accounted for about 43.7%, and substance use disorders for 30.1%.
At a time when official institutions stress the importance of promoting awareness of mental health and the need to treat it as an integral part of public health, the costs of the mental health and addiction services that the Ministry of Health used to provide at reduced prices have doubled, according to the new financial and administrative regulations, which have been applied since last August.
The costs of private hospitals and centres have also risen noticeably, with prices at licensed psychiatric clinics in Egypt starting from EGP 3,500 to EGP 10,000 per month, with this cost varying from one institution to another. Prices differ according to the patient’s condition, the nature of the treatment programme and the type of accommodation, as well as the level of additional services and the recreation facilities available, which a large number of citizens cannot afford, given a minimum wage that does not exceed EGP 8,000.
The General Secretariat of Mental Health and Addiction Treatment comprises 24 specialised hospitals and centres spread across 15 governorates, specialising in providing psychiatric care and addiction treatment services to citizens. In 2024, these facilities provided more than 624,000 medical services through their outpatient clinics in the period from January to October of the same year, in addition to providing more than 21,000 medical services in geriatric psychiatry outpatient clinics during the period from January to November 2025.
The State Commissioners Recommend Cancelling the Decree
In this context, the report of the State Commissioners Authority on 16 April came to intensify the controversy over mental health service pricing policies and to revive demands for supporting the psychiatric treatment system and cancelling the new financial regulations.
Under the slogan “The Right to Health”, the Egyptian Center for Economic and Social Rights considered that the report’s conclusion represents a clear bias in favour of citizens’ rights, and a step that may pave the way for an anticipated ruling by the State Council reconsidering the financial burdens imposed on patients.
The State Commissioners Authority at the Administrative Court recommended cancelling Health Minister Decree No. 220 of 2025, insofar as it omitted to stipulate explicitly that treatment is free for those unable to pay in emergencies and life-threatening cases, in the lawsuit filed by the Center in coordination with the “Our Fate Is One” campaign, while the report concluded that the lawsuit should be accepted in form, recommending the partial cancellation of the decree and ordering the administrative body to pay the costs.
The report relied on the fact that the right to health, including psychiatric care, is an inherent constitutional right that may not be restricted by financial ability, especially in critical cases. It explained that the regulations violated the constitutional text by failing to distinguish between emergency cases and life-threatening cases, and by not stipulating explicitly that both are covered by free treatment for those unable to pay.
It stressed that the absorptive capacity of health facilities is the only acceptable constraint on providing the service, not the patients’ financial ability, considering that continuing to apply the regulations in their current form constitutes a legal violation requiring partial cancellation.
For his part, lawyer Malek Adly, director of the Egyptian Center for Economic and Social Rights, says that the Center legally represents a number of guardians of psychiatric patients, as well as the “Our Fate Is One” campaign, which is concerned with defending the rights of psychiatric patients, explaining that the decision to raise the prices of treatment services in government mental health hospitals by up to about 330% has placed a heavy burden on families and created ambiguity regarding the mechanisms for dealing with cases whose admission to hospital is compulsory, especially those lacking legal capacity or patients unable to pay.
Adly adds to Zawia3 that the recent increases have pushed some families to take their relatives out of hospitals because they could not bear the costs, pointing to cases that ended tragically, which prompted the Center to challenge the decree, considering that applying it in this way “poses a real danger to the lives of psychiatric patients”, particularly given the nature of these illnesses, which require continuous treatment and cannot be treated as services that can be dispensed with or postponed.
He stresses that the challenge does not aim to reject the pricing of services absolutely, but demands that a distinction be made between those who can pay and those who cannot, so that the cost does not become an obstacle to receiving treatment, especially since the absence of psychiatric care may lead to loss of life or put the patient and those around them at risk. He expressed the hope that the court would arrive at a fair ruling that restores balance to the psychiatric treatment system, amid growing official talk about the importance of mental health after the recent incidents, noting that if the anticipated ruling cancels the Ministry of Health’s decree, the ministry will have to cancel the regulations and reconsider the service prices anew.
The Egyptian Center for Economic and Social Rights had filed a lawsuit numbered 86235 of Judicial Year 79 before the Administrative Court in Cairo, as agents for a number of those affected, including guardians and parents of a number of patients, as well as specialists and people interested in the field of psychiatry, against: the Minister of Health in his official capacity, the Secretary-General of the General Secretariat of Mental Health and Addiction Treatment in his official capacity, the head of the National Council for Mental Health in his official capacity, and the director of Abbasiya Hospital for Mental Health and Addiction Treatment in his official capacity, over the minister’s decision to raise the costs of care and treatment in mental health hospitals.
Under Decree No. 220 of 2025, the regulations stipulated that the cost of a patient’s stay ranges between EGP 150 and EGP 550 per day, depending on the accommodation class, excluding the costs of medical and treatment services. This compares with previous prices, when the cost of accommodation ranged between EGP 5 and EGP 200 per day.
In a paper issued by the Egyptian Center for Economic and Social Rights titled “Between Text and Application… The Social Protection Gap in Family and Mental Health Issues” following the suicide of the Smouha woman in Alexandria, the Center considered that relying solely on official statements focusing on awareness of the dangers of suicide, without addressing the economic, social and legislative roots of the crisis, reflects a clear deficiency in the response. It stresses that awareness, despite its importance, cannot replace fair public policies that guarantee a minimum of social protection, ease living pressures and provide effective mechanisms to support families, especially given the widening gap between legal texts and their actual application.
The Center points out that the continued setting of a low ceiling on the maintenance paid through Nasser Social Bank, alongside the rising costs of mental health services, deepens the fragility of the situation of women and children and undermines the right to social protection and health. It also notes that these imbalances reflect a structural flaw requiring urgent institutional and legislative intervention that ensures the effective enforcement of court rulings, links maintenance values to economic variables, and makes mental health services available in a fair and affordable manner, consistent with the state’s obligations to protect the groups most in need of care.
The Regulations Threaten Patients with Mental Disorders
The Arab Foundation for Civil Society and Human Rights Support had warned, in a report it published last September, of a worrying rise in suicides in Egypt, after it documented 216 cases during 2024, noting that the actual number may exceed this figure more than tenfold as a result of the lack of transparency and the failure of official bodies to announce accurate figures.
The report pointed out that the most common causes are linked to economic and social pressures, as well as mental disorders, family disputes, academic failure and delayed marriage, stressing that the most vulnerable group is young people between 21 and 30 years old, and that males account for about 65.7% of cases.
In this context, Dr Ahmed Hussein, coordinator of the campaign “Our Fate Is One”, one of the plaintiffs in the lawsuit and a former member of the Doctors Syndicate council, says that the campaign is an initiative bringing together a group of people concerned with health, and that it aims to counter the repercussions on society of the new financial regulations for the prices of mental health services. He explains that the impact of these regulations extends to social, judicial and economic dimensions, threatening the continuity of treatment for patients with mental disorders and addiction and deepening their crises.
Speaking to Zawia3, Hussein believes that health, and mental health in particular, is a matter of national security, since a psychiatric patient often goes through periods of instability that deprive them of the ability to make decisions or manage their life affairs, which reflects negatively not only on the patient but also on their family and the surrounding community, noting that some cases, such as severe depression, schizophrenia and suicidal tendencies, may turn into a direct threat to life or into dangerous behaviour if appropriate treatment is not received.
The former member of the Doctors council notes that the establishment of the General Secretariat of Mental Health in 1997 was undertaken by the late former President Mohamed Hosni Mubarak after a terrorist attack carried out by a person with mental disorders, considering that what is happening now is “a regression to the Dark Ages”, and that pricing mental health services represents a “societal catastrophe” that reflects negatively on the state as a whole, noting that studies in many countries confirm that the cost of not treating psychiatric and addiction patients reaches two and a half times the cost of treatment, meaning that treating patients saves the state more than not treating them costs it.
He also explains that the lack of treatment leads to the patient losing their productive capacity, and affects their family, one or more of whose members may be taken up with caring for them, in addition to social disintegration that may reach divorce or family crises, as well as the fact that addiction patients may resort to committing crimes to obtain drugs, with the resulting crimes, imprisonment and additional costs for the state.
The coordinator of the Our Fate Is One campaign and former member of the Doctors Syndicate council criticises what he described as short-sightedness regarding the real economic dimension when the decision was taken, noting that prices before the new regulations included 60% of beds free of charge and 40% at economy classes, starting from about EGP 5 per day and reaching EGP 200 in the hotel class, equivalent to between EGP 150 per month and about EGP 6,000, while after the new regulations the lowest accommodation price became EGP 150 per day, that is, EGP 4,500 per month, reaching EGP 11,500 per month, which has caused many patients to leave hospitals never to return.
The coordinator of the Our Fate Is One campaign believes that the decision is illogical even from a purely economic perspective, because it leads to greater losses for the state compared with the cost of treatment, that dealing with mental health in this way represents a serious regression, and that the opinions of specialists or of those who worked on the Psychiatric Patients’ Rights Law were not taken into account.
The World Health Organization published a study in the journal The Lancet Psychiatry on 13 April 2016, dealing with the integrated estimate of the health and economic returns of investing in the treatment of depression and anxiety at the global level. The study showed that the number of people with common mental disorders is steadily increasing, having risen from 416 million people in 1990 to 615 million people in 2013.
The study reviewed the costs of treatment and the health outcomes in 36 low-, middle- and high-income countries over fifteen years, from 2016 to 2030.
It concluded that the estimated costs of scaling up treatment, which mainly includes psychosocial counselling and antidepressant medication, amount to about US$147 billion. In contrast, the study showed that the returns clearly exceed these costs: improving workforce participation and raising its productivity by 5% is estimated at about US$399 billion, while improved general health adds about US$310 billion in additional returns, which reinforces the economic feasibility of investing in mental health services.
However, the organisation pointed out in its study that current investment in mental health services is far below what is needed. According to the 2014 survey of the organisation’s Mental Health Atlas, governments spend on average 3% of their health budgets on mental health, with the proportion ranging from 1% in low-income countries to 5% in high-income countries. The study concluded that every dollar invested in treating depression and anxiety can yield a return of up to four times its value, which reinforces the importance of integrating mental health into the priorities of health and economic policies globally.
The right to health is an inherent constitutional right in the Egyptian Constitution issued in 2014 and its 2019 amendments, as Article (18) stipulates that “every citizen has the right to health and to integrated healthcare in accordance with quality standards, and the state is committed to allocating a percentage of government spending to health of no less than 3% of the gross national product, to increase gradually until it is in line with global rates, and to establishing a comprehensive health insurance system that covers all citizens and includes all diseases”.
Decisions Detached from Reality
For her part, Dr Irene Saeed, a member of the House of Representatives’ Health Committee and head of the parliamentary bloc of the Reform and Development Party, says that she always disagrees with the Ministry of Health when it raises the financial regulations for providing health services, stressing that health services are a constitutional right, especially for ordinary people.
She adds to Zawia3 that amid the current economic crises, which are among the most important causes of the worsening of mental illness among citizens, the Ministry of Health appears detached from reality when it raises the prices of psychiatric treatment services, asking whether these services are linked to the dollar exchange rate, in the way the government justifies the rising cost of medicines and the increase in the bill for imported medical supplies, and stressing at the end of her remarks that reconsidering the financial regulations for health services is necessary.
In the same context, Elham Eidarous, a feminist activist and the founders’ representative of the Bread and Freedom Party (under formation), criticises the absence of official figures or accurate statistics on patients with mental disorders in Egypt, but based on her observations as a citizen, she tells Zawia3 that the number of people who suffer from mental disorders and live on the street appears to be increasing.
She notes that she frequently observes more than one homeless person or person with mental disorders around where she lives, whereas the number used to be lower, which she believes requires scientific and official study to determine its causes precisely.
Elham adds that what caught her attention were the amendments to the financial and administrative regulations of government psychiatric hospitals, particularly regarding the costs of long stays, chronic treatment and addiction treatment, as families unable to bear these costs will have no option but to leave patients untreated, while those who can afford it turn to the high-cost private sector, which may lead to some cases ending up on the street.
The feminist activist points out that policies of reducing public spending on health, along with the expansion of the privatisation of health services under names such as “management development” or “operating facilities”, are exacerbating the crisis, amid a shortage of psychiatrists and psychotherapists and the scarcity of the speciality in the first place, considering that this trend deepens the gap in service provision for poor groups and prevents psychiatric patients from obtaining the necessary care, which reflects negatively on society as a whole.
Regarding women, Eidarous believes that women suffer more in the field of mental health and addiction because of social stigma and fear of responsibility, which makes women more hesitant to seek treatment. She added that homeless women or women with mental disorders are exposed to more severe complications, including hunger and homelessness as well as violence and sexual assault, which makes their situation more fragile than that of men.
The Bread and Freedom Party had submitted a paper at one of the National Dialogue sessions, considering that mental health is a necessity and not a luxury. The paper considered in its introduction that mental health is an essential part of public health and that it must be integrated into the comprehensive health insurance system, amid increasing economic and social pressures that have greatly affected the rise in rates of mental disorders, especially among young people and women. It noted that young people, who make up about 21% of the population, are seeing a marked rise in rates of drug use and addiction, along with escalating violence against women, which reflects the widening gaps in social protection and care.
The paper stressed that the addiction treatment and mental health system in Egypt faces structural challenges, most notably a shortage of medical and psychological staff, the migration of doctors and the absence of clear professional regulation for psychologists, in addition to weak coordination between the relevant bodies and an uncontrolled expansion of unlicensed treatment centres. It also links these conditions to declining public spending on health and the state’s trend towards privatising services, which limits the ability of the groups most in need to obtain appropriate treatment and care.
As for solutions, the paper called for increasing investment in mental health and making it a priority within health policies, and for developing an integrated national strategy that includes prevention, treatment and the social reintegration of those who have recovered, while providing trained staff and incentivising them financially and professionally.
It also proposed integrating psychological support services into schools, universities and workplaces, and establishing specialised units in hospitals and police stations, along with developing the legal framework to guarantee protection from violence, especially against women, and strengthening cooperation between the state and civil society to expand the scope of services and ensure their fairness.
The recurring incidents of suicide and the escalating controversy over the rising costs of psychiatric treatment reveal that the mental health crisis in Egypt is no longer an individual matter or a marginal file, but has become a social and economic issue that affects the security of society as a whole. As living pressures increase and the gap between the need for treatment and the ability to afford it widens, the need for fairer public policies that guarantee access to mental health services for all appears urgent.
Editorial correction: The number of the Minister of Health and Population’s decree appeared incorrectly in the first version of the report (2020 of 2025); the correct number is 220 of 2025.
